Uterine sarcomas versus leiomyomas: Gray‐scale and Doppler sonographic findings

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Abstract
Purpose The aim of the study was to evaluate the contribution of gray‐scale sonography and Doppler flow studies in differentiating between uterine sarcomas of different histologic types and leiomyomas. Patients and Methods The study included 111 patients, divided retrospectively into 2 groups: 98 patients with leiomyomas and 13 with postoperative diagnosis of uterine sarcoma. This latter group was further divided into a group of 6 patients with uterine leiomyosarcoma and 7 with malignant mixed mesodermal tumor. The gray‐scale sonograms and Doppler parameters in the 3 groups were compared. Results The patients with leiomyomas were younger than those with sarcomas (52 years ± 11 versus 65 years ± 15, p < 0.05). No differences were noted between the 3 groups regarding gravidity, parity, symptoms upon admission, or findings during physical examination. The sonographic appearances of the leiomyomas were similar to those of the leiomyosarcomas, but in 6/7 cases, they were different from those of the malignant mixed mesodermal tumors. There was a significant difference between the mean resistance index in arterioles of the leiomyomas (0.59 ± 0.01) and that of the malignant mixed mesodermal tumors (0.41 ± 0.06) (P < 0.001) but not between those of the leiomyomas and the leiomyosarcomas (0.49 ± 0.18). Conclusions Doppler flow studies may assist in differentiating between leiomyomas and malignant mixed mesodermal tumors but not between leiomyomas and leiomyosarcomas. © 2004 Wiley Periodicals, Inc. J Clin Ultrasound 33:10–13, 2005